Effects of exercise training for heart failure with preserved ejection fraction : a systematic review and meta-analysis of comparative studies

Taylor, R. , Davies, E. J., Dalal, H. M., Davis, R., Doherty, P., Cooper, C., Holland, D. J., Jolly, K. and Smart, N. A. (2012) Effects of exercise training for heart failure with preserved ejection fraction : a systematic review and meta-analysis of comparative studies. International Journal of Cardiology, 162(1), pp. 6-13. (doi: 10.1016/j.ijcard.2012.05.070) (PMID:22664368)

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Abstract

Introduction We conducted a systematic review to assess the effect of exercise training in patients with heart failure with preserved ejection fraction (HFPEF). Methods A number of electronic databases were searched up to November 2011 to identify comparative studies of exercise training in HFPEF. Where possible, outcome data from included studies were pooled using meta-analysis. Results Three randomised controlled trials, one non-randomised controlled trial and one pre-post study were included, for a total of 228 individuals. The combined duration of exercise programmes and follow-up ranged from 12 to 24 weeks. No deaths, hospital admissions or serious adverse events were observed during or immediately following exercise training. Compared to control, the change in exercise capacity at follow-up was higher with exercise training (between group mean difference: 3.0 ml/kg/min, 95% CI: 2.4 to 2.6). In the four studies, that reported the Minnesota Living with Heart Failure questionnaire, there was evidence of a larger gain in health-related quality of life with exercise training (7.3 units, 3.3 to 11.4). The largest study showed some evidence of improvement in the E/E′ ratio with exercise training, but this was not confirmed in the other studies (overall − 0.9, − 3.8 to 2.0); E/A ratios were not changed. Conclusions Exercise training for patients with HFPEF confers benefit in terms of enhancements in exercise capacity and health-related quality of life and appears to be safe. The impact on diastolic function remains unclear. Further trials should provide data on long term effects, prognostic relevance and cost-effectiveness.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Taylor, Professor Rod
Authors: Taylor, R., Davies, E. J., Dalal, H. M., Davis, R., Doherty, P., Cooper, C., Holland, D. J., Jolly, K., and Smart, N. A.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:International Journal of Cardiology
Publisher:Elsevier
ISSN:0167-5273
ISSN (Online):1874-1754
Published Online:02 June 2012

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